When 25-year-old Karthik, who hails from a village in Karnataka, joined an advertising firm in Mumbai, his colleagues would often comment on the smell of his perfume. Born into a Dalit family, Karthik was only the second person to get the opportunity to go to college – and the first person to work outside their home state.
"They [the colleagues] would ask me what perfume I used and would start laughing. I changed my perfume, but they still continued to laugh. Then I realised it was not the perfume, but me. When I raised this with my therapist, she saw this as a class divide, but not as a caste divide," Karthik tells The Quint.
For Divya Kandukuri, a senior projects associate at Zubaan Books, a feminist publishing house, her first bad experience with a therapist was when she was a 19- or 20-year-old student in Delhi University. Campuses had been charged with conversations around caste politics after the tragic death of Rohith Vemula in 2016 and Dr Payal Tadvi in 2019 – both of whom had faced caste-based discrimination.
"I spoke to my therapist about how the general chatter around reservation in my college made me question my abilities. But instead of assuring me that their point of view is the cause of concern, the therapist told me that I should 'work hard and not be lazy.' I felt terrible, and it was my friends who told me that the therapist should not have said this," Divya told FIT.
Seeking mental health support, in general, can be challenging in India. But for people from the marginalised communities in India, including those from Dalit-Bahujan-Adivasi communities, it's like an obstacle race.
Blatant caste discrimination in educational institutions and workplaces, news of caste-based violence, and the pressure of fighting for social justice are affecting the everyday lives of young professionals from the community.
While affordability and stigma remain key concerns in seeking mental healthcare, many who do have the privilege of seeking therapy feel that they do not get the help they deserve.
Caste & Mental Health: What Data Shows
There are credible studies that ascertain the link between social disadvantage and mental health.
A 2015 study, published in the British Medical Journal, shows that there were 'higher levels of depression among people from lower castes as compared to higher castes' in the Dehradun district of Uttarakhand.
Another recent study found that mothers from Scheduled Castes and Scheduled Tribes, who had recently given birth, had higher odds of mental distress as compared to their dominant-caste counterparts.
A research paper from Nepal, which has similar caste structures as India, found that Dalits are more likely to have depressive episodes when compared to 'higher-caste Brahmins and Chhetris.'
'Therapists Don't Utter the Word 'Caste''
Shilpa's (name changed) manager – a Brahmin – at an architecture firm in Delhi would never let her make presentations to clients. "They wouldn't understand your accent," she would be told. This led her to constantly question her ability – pushing her to seek therapy.
"I saw a therapist for almost three months, and she was convinced that I am facing gender discrimination at work – and how I should be an empowered woman at work. Which may be true, but it does intersect with my caste background – and despite me raising it repeatedly, she wouldn't address it, and that's when I knew it wasn't working out. I had some insight into this, but what if it was someone who didn't have this awareness?"
The hesitancy of therapists to acknowledge caste as an issue also means that people 'worry' about coming out with their caste identity in therapy sessions. Like 31-year-old Mohit (name changed), who joined a top school in Mumbai as a middle school teacher earlier in January.
"I know I worked very hard to be here, but I don't know how to connect with my colleagues. I have not been in a space that only has people from privileged castes before. I don't think many people from work know that I am a Dalit person. A friend suggested therapy, but after two months, I couldn't open up to the therapist about my caste identity either."
'Problem Arises When Therapists Don't Get Context'
There are no government programmes in India that seek to connect those who are from marginalised communities with the right therapists. But there are community-level organisations working towards bettering access, like the Blue Dawn – a collective co-founded by Divya that has been connecting Bahujan individuals with therapists for the last five years.
"People think: do I have to explain my identity, would they judge my culture and practices? Would they say that my concerns are just in my mind? Is my identity going to be deleted?" Ahla Matra, a Mumbai-based psychologist, who has been practising for over six years, had told FIT.
Divya seconds this. "A majority of therapists in India are from the dominant caste communities. Which is fine, and we have referred to people to those who understand caste and have an honest approach to it. The problem arises when people do not get the context. It can go really bad and harm the person seeking therapy."
There are also studies on how a non-Dalit therapist can potentially turn a Dalit individual away from therapy.
In her 2021 paper, published in Global Journal on Social Exclusion, scholar Meena Sawariya writes about cultural differences that "can give rise to cultural anxiety, a feeling of disconnect, or a fear of being judged and misunderstood, which can all lead to new trauma."
If the therapist is also a Dalit individual, she argues, there are much better chances of the therapist relating to the client's lived experiences. This leads to mutual healing, she says.
To put this into further context, surveys indicate India has only about 9,000 psychiatrists for its 1.3 billion people. In the United States, on the other hand, there are about 28,000 psychiatrists for a population of 325 million.
This not only means that access to therapy is limited, it also raises the question of whether those who are seeking therapy are getting the right kind of help from someone who understands how caste plays out in the socio-politics of the country.
"If a therapist believes that caste does not exist, and even if the person is screaming at the top of their voice, the therapist will not hear it," says Dr Raviraj Shetty, the co-founder of Narrative Practices India. Shetty practises narrative therapy, which aims to separate the individual from the problem, enabling the individual to externalise their issues.
"When I was being trained to be a psychologist, all my teachers were Brahmins, there was no conversation about, say, gender, sexuality, or caste – it was like an extra credit course. Personally, when I ask a therapist of mine or my supervisor about this, and they say they do not know about their caste or how it impacts them, then I think that is a major blind spot," says Prachi, who is a psychologist from Barabanki in Uttar Pradesh.
But there's also more nuance, says Chennai-based psychotherapist and public health researcher Sannuthi Suresh.
"In the first couple of sessions, we speak about what brings them to therapy, and what they seek from it. One doesn't have to directly ask someone what caste identity they possess. Sometimes they offer the information, and sometimes it comes up during the course of the conversations."
"But there are various levels of intersectionality. A woman who is facing gender and caste-based discrimination, a queer person facing intersectional discrimination stemming from their sexuality and caste. Also, even people who come from Dalit-Bahujan-Adivasi communities are not one coherent group. Each of these aspects come with the need for a deeper understanding," she says.
What Therapists Should Actually Be Doing
Take a Stand:
Dr Raviraj says that therapists should throw out the idea that they are 'neutral.'
"Therapists are trained to be neutral, but neutrality is a concept in physics and not really human beings. When you are assuming to be neutral, then you are also telling someone that the discrimination they have faced because of their caste is invalid."
Reflect On Self:
Divya says that one thing she always tells therapists, during workshops on providing care for persons from the community, is to also reflect on how caste plays out in your own home.
"Do you think caste does not exist, but do you still have different vessels for your domestic help?" she says.
Read Up On the History of Caste:
"Start reading about the history of caste, what the leaders have said. The more you read, the more your consciousness grows, and the more you reflect on the questions you are asking. Read up about how caste has an impact in the world we are living in today," Dr Raviraj added.
Make Therapy More Accessible:
Sannuthi says that people who live with these experiences may many times not have the privacy that conventional or video-based therapy requires and one needs to adapt to what suits the person best.
"I facilitate therapy on phone calls sometimes. I don't insist on video calls or in-person meetings if it makes the person uncomfortable or is not possible of them," she adds.